title: [White matter abnormalities following attempted suicide].
abstract: BACKGROUND
  Delayed post-hypoxic leukoencephalopathy (DPHL) is a demyelinating disorder characterized by neuropsychiatric symptoms occurring a few days to some weeks following cerebral hypoxia.
  
  
  METHODS
  A 50-year old female patient showed rapidly progressive cognitive deterioration with apathy, mutism and regressive behaviour a few weeks after a suicide attempt with carbon monoxide (CO). This eventually leads to a state of akinetic mutism. Magnetic resonance imaging (MRI) of the brain showed diffuse white matter abnormalities. These MRI findings combined with CO intoxication and the clinical picture were highly suggestive for DPHL.
  
  
  CONCLUSIONS
  This case emphasizes that a neurological cause should be considered if rapidly progressive neuropsychiatric symptoms occur, and that after suspected auto intoxication it is important to take possible hypoxia and its after-effects into consideration. Recognition of DPHL is important so that unnecessary invasive diagnostics and treatment can be avoided. Considering the favorable natural course of DPHL appropriate measures should be taken in order to provide supportive care and rehabilitation.
authors.affiliation: Medisch Centrum Leeuwarden, afd. Neurologie, Leeuwarden.
authors.forename: Linda
authors.initials: L
authors.lastname: Rolf
authors.forename: Tineke
authors.initials: T
authors.lastname: Sikkema
authors.forename: Judith
authors.initials: J
authors.lastname: Krudde
authors.forename: Barbera
authors.initials: B
authors.lastname: van Harten
mesh_terms: D000405:Akinetic Mutism / Q000209:etiology / Q000473:pathology; D001921:Brain / Q000473:pathology; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D002534:Hypoxia, Brain / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D056784:Leukoencephalopathies / Q000175:diagnosis* / Q000209:etiology; D008279:Magnetic Resonance Imaging / Q000009:adverse effects; D008875:Middle Aged; D013406:Suicide, Attempted